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移植前可溶性CD30血清浓度不影响移植后3年的肾移植结局。

Pretransplant soluble CD30 serum concentration does not affect kidney graft outcomes 3 years after transplantation.

作者信息

Kovač J, Arnol M, Vidan Jeras B, Bren A F, Kandus A

机构信息

Department of Nephrology, University Medical Center, Ljubljana, Slovenia.

出版信息

Transplant Proc. 2010 Dec;42(10):4043-6. doi: 10.1016/j.transproceed.2010.09.050.

Abstract

INTRODUCTION

An elevated serum concentration of soluble the form of CD30 (sCD30), an activation marker of mainly T(H)2-type cytokines producing T lymphocytes, has been reported as a predictive factor for acute cellular rejection episodes and poor graft outcomes in kidney transplantation. This historic cohort study investigated the association of a pretransplant sCD30 serum concentrations with kidney graft function and graft survival 3 years posttransplantation in adult recipients of deceased donor kidney grafts, treated with monoclonal anti-CD25 antibodies as an induction treatment combined with a cyclosporine (CsA)-based maintenance triple therapy.

MATERIALS AND METHODS

The pretransplant sera of 296 recipients were tested for sCD30 content using a microsphere flow-cytometry assay. The estimated glomerular filtration rate (eGFR) was determined by the 4-variable Modification of Diet in Renal Disease equation. The incidences of graft loss were calculated with the use of Kaplan-Meier survival analysis and compared using the log-rank test.

RESULTS

According to the distribution of the pretransplant sCD30 levels concentration ≥2700 pg/mL was defined as high (n = 146) and concentration <2700 pg/mL as low (n = 150). Three years posttransplantation, the eGFR was not significantly different in the recipients in high and low sCD30 groups (65 ± 24 vs 67 ± 21 mL/min/1.73 m(2); P = .43); there was no association between the eGFR 3 years after transplantation and the pretransplant sCD30 levels (r(2) = 0.002; P = .49). Graft survival 3 years after transplantation was also not different in the recipients in high and low sCD30 groups (P = .52).

CONCLUSION

In our adult deceased-donor kidney graft recipients, the pretransplant sCD30 serum concentration was not a predictive factor of immunologic risk associated with the kidney graft function 3 years posttransplantation; neither did it affect graft survival 3 years after transplantation. The immunosuppression with anti-CD25 antibodies as an induction treatment combined with the CsA-based maintenance triple therapy could possibly be decisive for our findings.

摘要

引言

可溶性CD30(sCD30)血清浓度升高,sCD30是主要产生T(H)2型细胞因子的T淋巴细胞的一种激活标志物,据报道它是肾移植中急性细胞排斥反应发作和移植效果不佳的预测因素。这项历史性队列研究调查了在接受单克隆抗CD25抗体诱导治疗并联合基于环孢素(CsA)的维持三联疗法的成年已故供体肾移植受者中,移植前sCD30血清浓度与移植后3年肾移植功能及移植肾存活之间的关联。

材料与方法

采用微球流式细胞术检测296名受者移植前血清中的sCD30含量。使用4变量的肾脏病饮食改良方程确定估算肾小球滤过率(eGFR)。采用Kaplan-Meier生存分析计算移植肾丢失的发生率,并使用对数秩检验进行比较。

结果

根据移植前sCD30水平的分布,浓度≥2700 pg/mL被定义为高水平(n = 146),浓度<2700 pg/mL被定义为低水平(n = 150)。移植后3年,sCD30高水平组和低水平组受者的eGFR无显著差异(65±24 vs 67±21 mL/min/1.73 m²;P = 0.43);移植后3年的eGFR与移植前sCD30水平之间无关联(r² = 0.002;P = 0.49)。sCD30高水平组和低水平组受者移植后3年的移植肾存活率也无差异(P = 0.52)。

结论

在我们的成年已故供体肾移植受者中,移植前sCD30血清浓度不是移植后3年与肾移植功能相关的免疫风险的预测因素;它也不影响移植后3年的移植肾存活。以抗CD25抗体作为诱导治疗并联合基于CsA的维持三联疗法的免疫抑制可能是我们研究结果的决定性因素。

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